Aissaoui N, et al. - Authors in this study compared heart transplantation (HT) and ventricular assist devices (VAD) for the management of end–stage heart failure regarding the outcomes and use of resources in 2 European countries with different allocation systems. Findings supported HT as the first option for end–stage heart failure patients. HT seemed associated with improved outcomes and better cost–effectiveness profile. They suggested considering VAD devices as an option when transplant was not possible or when patient presentation was not optimal.